Remote Pharmacy Contract Audit Analyst

Navitus; Saint Paul (MN); Remote; USD 55,000 - 75,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

PTO: 20 days

Parental leave: 4 weeks

9 paid holidays

401K company match

Adoption Assistance

Flexible Spending Account

Education Assistance

Referral Bonus Program

Job summary

Navitus Health Solutions is seeking an Analyst, Pharmacy Contract Audit to oversee contractual pharmacy network reimbursement accuracy across Retail, Specialty, and Mail Order channels. The role requires analytical review of claims data, contract term interpretation, and the creation of controls and reports to ensure compliance.

You will work with Navitus’ NCRx adjudication system and PC2 databases, analyzing provider data and communicating findings to internal teams for remediation, all within

Qualifications

• Bachelor’s degree or equivalent experience required in business, finance, economics, or operations.
• Minimum two years analytics experience required.
• Participate in, adhere to, and support compliance program objectives.
• Ability to interact cooperatively and respectfully with other employees.

Responsibilities

• Analyze Navitus’ reimbursement programs (AWP, WAC, MAC, NADAC, FUL, AAC, other pricing structures).
• Field inquiries from providers, clients, auditors, and internal teams about pricing errors and root causes.
• Interpret contract language to compare contract pricing to adjudicated claims activity.
• Develop controls and oversight reporting for end-to-end contract pricing processes.
• Test pharmacy network rates, perform chain audits, assess impact on pricing.
• Make decisions to resolve network pricing setup issues.
• Submit service or recovery requests and coordinate system updates.

Skills

Analytical skills

Contract interpretation

Data analysis

Communication

Education

Bachelor’s degree or equivalent

Tools

NCRx

PC2

Job description

Navitus Health Solutions is seeking an Analyst, Pharmacy Contract Audit to oversee contractual pharmacy network reimbursement accuracy across Retail, Specialty, and Mail Order channels. The role requires analytical review of claims data, contract term interpretation, and the creation of controls and reports to ensure compliance.

You will work with Navitus’ NCRx adjudication system and PC2 databases, analyzing provider data and communicating findings to internal teams for remediation, all within